Provider First Line Business Practice Location Address:
781 EASTERN BYP
Provider Second Line Business Practice Location Address:
PATTIE A. CLAY HOSPITAL
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40475-2408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-623-8827
Provider Business Practice Location Address Fax Number:
859-623-8810
Provider Enumeration Date:
06/21/2006